AVP, Stars and Risk Adjustment – National Medical Director (Healthcare)

Location: Remote nationwide within the United States; occasional travel to hirify.global offices for training or meetings may be required.

Salary: $246,100–$344,200 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services for Medicare, Medicaid, families, individuals, military personnel, and communities.

What you will do

• Provide clinical leadership and subject matter expertise for STARS and risk adjustment initiatives.
• Engage physicians, physician groups, providers, and market leadership to improve satisfaction and participation in quality and risk adjustment programs.
• Oversee Stars self-reporting metrics, provide physician-level clinical interpretation, and escalate issues requiring medical leadership.
• Participate in CMS audits and ensure risk adjustment activities meet regulatory, policy, and quality requirements.
• Lead the team responsible for risk adjustment education and oversee provider-facing training, materials, reporting, and feedback loops.
• Develop and monitor KPIs, analyze clinical and quality data, and identify performance improvement opportunities.

Requirements

• MD or DO degree required.
• Experience in clinical leadership, preferably in managed care, risk adjustment, or quality improvement.
• Experience with risk adjustment and STARS programs.
• Ability to lead and develop high-performing teams and build relationships with provider organizations.
• Experience developing and monitoring KPIs, reporting, and educational programs for healthcare leaders.
• Ability to interpret clinical and quality data to drive performance improvement.

Culture & Benefits

• Remote work with a dedicated workspace that protects member PHI and HIPAA information.
• Home internet requirements: at least 25 Mbps download and 10 Mbps upload.
• Medical, dental, and vision benefits, 401(k), paid time off, holidays, and paid parental and caregiver leave.
• Short- and long-term disability, life insurance, and additional wellness benefits.
• 40 scheduled hours per week.